Epidemiology Of Osteoporosis Treatment In Women - An Indian Perspective
Osteoporosis is a bone problem characterized by the deterioration of bone tissue and loss of bone mass. Bone is a vital part that gives a definite structure to our body. When the bone mass is insufficient, there is a high risk of fractures.
Earlier, osteoporosis was considered incurable, and people had to bear the consequences. But with recent advances in medicine, several effective treatment options are available to manage osteoporosis. But does everyone have equal access to treatment? Are women more susceptible to osteoporosis? If so, how? Let us discuss in detail the epidemiology of osteoporosis in women of India.
Epidemiology Of Osteoporosis In Indian Women
Osteoporosis affects about 18.3% of people worldwide. Fractures that occur after a minimal injury or trauma, especially in the spinal regions, are the most common and earliest indications of osteoporosis. Fractures are also an important cause of morbidity and mortality in Indian patients with osteoporosis. They have been reported to occur much earlier in Indians than in people in other countries.
A study published in 2015 reported that about 46 million women from India suffer from osteoporosis. This is why osteoporosis is considered a major health issue among Indian women.
Risk Factors That Decide The Epidemiology Of Osteoporosis In Indian Women
1. Low Calcium In Diet
Low calcium intake is predominant among children, adolescents, and pregnant and breastfeeding women. The difference in calcium intake is greater among people with lower socio-economic status. In economically weaker sections of society, the calcium intake in women is much lesser than that of men. The phytates and oxalates present in the fiber-rich Indian diet also play a part in slowing down calcium absorption.
2. Deficiency Of The Sunlight Vitamin
Although we do not have a shortage of sunlight in India, Indians are highly prone to vitamin D deficiency, irrespective of age. Poor dietary calcium, environmental pollution, sociocultural reasons, and a higher concentration of an enzyme called 25(OH)-d-24-hydroxylase are some of the main reasons Indians have vitamin D deficiency.
3. Age During Each Hormonal Change
The average age at which girls reach the stage of puberty in our country is 12.5 years. The age at which they undergo menopause is much earlier than in other countries. Thus the age-related risk factor is higher in Indian women.
4. Rapid Changes In Lifestyle
Since our lifestyles are becoming faster, we have become more sedentary with low sun exposure and low physical activity. These are extremely problematic for bone health in the long run. Lack of movement and physical activity is one of the major reasons for low bone mineral density among Indian women.
Epidemiology Of Osteoporosis Treatment In Women
Calcium and Vitamin D supplementation is the first-line approach to treating osteoporosis. Studies have reported that these supplements effectively reduced the number of fractures. In severe cases, making a shift to other pharmacological treatments is necessary.
Bisphosphonates like Alendronate, risedronate, and zoledronic acid are often prescribed along with calcium and Vitamin D supplements. These medicines reduce the risk of fractures by 40-50% in people who have suffered vertebral fractures before. After menopause, the estrogen hormones decline, drastically accelerating the process of bone loss. Thus, postmenopausal women benefit from hormone replacement therapy.
Calcitonin reduces the occurrence of fractures by 30% in women who have experienced vertebral fractures previously. However, this hormonal therapy has not been proven to reduce the risk of non-vertebral fractures.
Parathyroid hormone therapy is another form of hormone replacement therapy that increases bone mineral density and reduces the risk of fracture to a great extent. Risk factors do not predict fractures and low bone density. However, evaluating the risk factors is useful to check whether the causes can be modified. Your physician will decide the appropriate treatment and prevention strategies by checking your risk factors. There are several treatments for osteoporosis. But since people from low economic backgrounds will not be able to afford the cost of diagnosis and treatment, the treatment option will be decided based on the patient's affordability. This is a major reason why many do not prefer getting treatment.
Elderly people have a greater risk of developing a fracture, increasing with age. Calcium, Vitamin D, and bisphosphonates are the first-line medicines to treat osteoporosis in Indian women. Other treatments are decided based on the person's affordability. Though awareness about osteoporosis has improved, we still have a long way to go regarding timely diagnosis and management.
Preventing osteoporosis is crucial to saving ourselves from extreme pain and burden. If you are aged above 65 years or have reached menopause, it is mandatory to check your bone mineral density levels at least once a year. Try to prevent falling down as much as possible. Exposure to sunlight for at least 15 minutes a day and eating foods rich in calcium and vitamin D. Regular weight-bearing and muscle-strengthening exercises are also essential.
